Agenda item

To receive an update on the work of the Care Quality Commission in Wokingham Borough, focusing in particular on Primary Care. (20 mins)

Nicola Cliffe (Primary Medical Services Inspection Manager, Thames Valley Team) provided an update on the work of the Care Quality Commission (CQC) and in particular Primary Medical Services.

During the discussion of this item the following points were made:

·         The purpose of the CQC was to make sure health and social care services provided people with safe, effective, compassionate, high-quality care.  The CQC also encouraged care services to improve.

·         The CQC monitored, inspected and regulated services to make sure they met fundamental standards of quality and safety.  The CQC published what they found including performance ratings to help people choose care.

·         The Committee noted the CQC approach to regulation.  It was noted that the registration process was being updated.  Ratings were not currently provided for dentists and independent health services.

·         The CQC had inspection teams with responsibility for:

o   Hospitals;

o   Adult Social Care;

o   Primary and Integrated Care

·         The Primary and Integrated Care Team inspected GP practices, out-of-hours services, dentists, prison healthcare and healthcare in children’s’ services. 

·         GP Practices could be rated ‘Outstanding’, ‘Good’, ‘Requires Improvement’ or ‘Inadequate.’  Reports were published once inspections had been carried out.

·         The CQC had published 2,375 inspection reports (as of 31 December 2015) on Primary Medical Services since it had begun using the new inspection methodology. 

·         Nationally 4% of Practices inspected had been rated ‘Outstanding,’ 80% ‘Good’, 12% ‘Requires Improvement’ and 4% ‘Inadequate.’

·         A key theme from inspections across the country was a link between good care provided and good leadership and similarly a link between poor care and poor leadership. 

·         Councillor Miall asked when the CQC would step in should a practice receive an unfavourable rating.  Members were informed that if a practice had been rated ‘Requires Improvement’ for one area they could be given up to a year to make improvements before a follow up inspection or a desk top review was carried out.  If a practice was rated ‘Inadequate’ it was re-inspected 6 months later.  If insufficient improvement had been made the CQC could take action such as either suspending the regulated activity or closing the practice.  Some practices in Reading had been rated ‘Inadequate’ and there had been closures but no practices in the Borough had been rated ‘Inadequate.’

·         Councillor Richards questioned what happened to patients if their surgery was closed.  Nicola Cliffe referred to a practice in Reading which had had its regulated activity suspended for four weeks.  During that time patients had been asked to use the Reading Walk In Centre.  NHS England had written to all patients at the surgery to explain the situation.  Councillor Richards went on to ask whether practices rated ‘Inadequate’ were fined and was informed that practices would be offered the support of the Royal College of General Practice, for which the practice paid half and NHS England paid the other half.

·         Members noted what could lead to inadequate care including weak leadership, isolated working and a poor culture of safety. 

·         Councillor Blumenthal asked how often GP practices would be inspected.  Nicola Cliffe commented that all practices across the country would be inspected by the end of September.  How often practices would be inspected would then be reviewed.  It was possible that a self-assessment process would be included as part of the future inspection process.

·         The CQC sought to develop links with scrutiny committees.  Members were requested to encourage residents to contact the CQC should they have any feedback on GP practices, positive or negative.  There were various ways in which contact could be made including completing a ‘Share your experience’ form.

·         Councillor Swaddle asked about Wokingham GP practices.  The Committee was informed that only three practices within the Borough had been inspected so far.  Wokingham Medical Centre and Loddon Vale had been rated ‘Requires Improvement’ and Wilderness Road had been rated ‘Good.’  There had been some concerns regarding access at one practice and medication management at another.  Nicola Cliffe indicated that further information would be available at the end of Quarter 1, which she would circulate to the Committee.  She also hoped to have information regarding dentistry available. 

·         Nicola Strudley commented that Healthwatch had undertaken a number of Enter and Views in care homes and that what Healthwatch heard sometimes differed to what the CQC heard as part of its formal inspection process.  Thames Valley Healthwatch network had suggested that Healthwatch reports should sit with CQC reports.  Nicola Cliffe indicated that she would feed this back. 

·         Councillor Miall asked whether the CQC fed back to Healthwatch and vice versa.  Nicola Cliffe indicated that they did and that a quarterly feedback meeting was held between the CQC, Healthwatch, CCG and NHS England.

RESOLVED:  That Nicola Cliffe be thanked for her presentation.